What is Bite Equilibration?
Often, teeth and jaws do not occlude (come together) in an acceptable position. The result is called malocclusion and has been related to muscle pain and breakdown of the dental structures. Some reasons for malocclusion are fillings, crowns or bridges that have been placed piecemeal over a period of years, tooth loss and resultant drifting and tipping of the remaining teeth, orthodontics, developmental defects, trauma, natural occurring malocclusion, grinding and clenching.
Occlusal Equilibration is the precise adjustment or reshaping of your teeth, dentures, bridges, fillings, or other oral appliances to achieve a more ideal, minimum-stress bite and jaw relation. In doing so, eliminates the tooth interferences that create forces that are destructive to teeth, the jaw joint, and jaw muscles. The overall goal is to promote maximum comfort and longevity of the natural teeth.
What if I don’t have an ideal bite?
A malocclusion interferes with the proper seating of the jaw at the joints and forces the jaw into an awkward position. The muscles have to compensate by actively holding the jaw in this unseated position. There is also destructive lateral force on the back teeth. The system is “out of balance” and the extra stress can lead to any one or more of the problems listed in the following table “Effects of Malocclusion”.
What are the benefits of Occlusal Equilibration?
A bite correction harmonizes the bite so the joints can seat properly and the muscles can act in a more coordinated fashion. A bite correction will treat TMD symptoms. 95% of TMD problems are attributed to an improper bite. Correcting the bite should eliminate the muscle pain and dysfunction and headaches associated with TMD. A bite correction is also preventive. By eliminating the heavy contacts on back teeth in jaw movement, it minimizes the above problems caused by stress on the teeth and jaw joints. Fillings and crowns last longer and various related ailments disappear often improving your overall health.
Is Occlusal Equilibration harmful to the teeth?
Occlusal equilibration is the removal of small amounts of tooth structure in a controlled, precise manner for the very purpose of preserving and protecting the teeth and other structures– it is in no way harmful. When malocclusion is present some problem exists: pain, joint clicking, abnormal wear, breaking of restorations (crowns), or other condition that is very damaging to the teeth. If the problem is left to progress the damage from uncontrolled wear, tooth fracture, etc is much greater than the minimal amounts we would remove during the procedure. Because removal is minimal and confined to the inclines of cusps (chewing surfaces of the teeth), in no way does it encourage tooth decay either. Decay normally starts in the pits at the bottom of the grooves of the teeth or at the contact points between the teeth.
The ideal, minimum-stress bite
When we talk about an ideal “minimum-stress” bite we start with your mandible (lower jaw). Your mandible has two heads or balls on both sides called “condyles” that connect to your skull at the jaw joints (TMJ). In the joints the condyles sit in fossa (sockets) and in an ideal bite both condyles should be fully seated in their respective fossa. In this seated position the jaw, like a door, swings on it’s hinge created by the axis through the two joints. When the teeth come together on this hinge axis, in a “clenching type” position, all teeth should contact simultaneously and evenly. Their should not be any high spots on teeth that would interfere and shift the jaw out of the fully-seated joint relationship. (Note in the diagram: the red dot is in the middle of the cross and the teeth in a full bite). Finally in an ideal bite, when you shift your teeth side to side and forward, your front teeth should be the only teeth contacting, separating and protecting your back teeth. Your front teeth are well-suited to withstand the lateral force that at the same time can be very harmful to your back teeth.
What is involved in Occlusal Equilibration?
Diagnosis and Treatment Planning
Careful planning is needed to determine what treatment is required to achieve an ideal bite. To plan, we require plaster models of your teeth attached to an articulator (jaw simulator). We will then carefully study and/or alter them to determine the severity of your bite problem. Final decisions are always verified on the plaster models of your mouth. In most cases bite correction or occlusal adjustment is all that is needed to correct the problem. If the bite problem is more severe other procedures such as crowns, orthodontics and in very severe cases jaw surgery will be required for correction.
Splint Therapy
If you have sore jaw muscles you will most likely need to wear a splint to initially relax and heal these jaw muscles. Sore tense jaw muscle make it difficult to determine your proper, most comfortable jaw joint position. Most important, if you get relief of your TMD symptoms with a splint this will verify that your problems were related to your bite and a bite correction is indeed the proper treatment.
Procedure
Since reshaping is only done on the enamel of the tooth, no discomfort will be felt and thus does not require anesthesia. Using the Bilateral mandibular manipulation technique to guide your jaw to the most seated position in the fossa, we mark the first contact point between your upper and lower teeth with carbon paper.
This contact point is an interference and is smoothed down so it no longer interferes. The process is repeated until all the teeth touch simultaneously with equal intensity when the TMJ is in the correct position and the muscles relaxed. During the procedure, the mouth must be kept dry so the paper can mark so this could be a slight annoyance.
Appointments
It is not known in advance precisely how much time will be required to render adequate treatment. Most mouth conditions are best treated with one extended appointment of about 80 minutes and two shorter follow-up sessions. The two follow-up appointments are needed because slight changes in your occlusion (bite) occur over a period of time, because of small movements of teeth in the jaw bones. More complex equilibrations may require several appointments, and the teeth may shift significantly between appointments. When your symptoms are gone, and your occlusion is relatively stable, your occlusal equilibration will be finished.
What should I expect after treatment?
The chewing surfaces of the teeth will feel a little rough for a few days after treatment and will last until these surfaces wear slightly from chewing. There may also be some temporary sensitivity.
Will the chewing surfaces of my teeth look different?
As a general rule, the amount of tooth structure that is removed in an occlusal equilibration is very minimal and it will be difficult for you to detect visually the change in the chewing surfaces.
Will Occlusal equilibration relieve my headaches?
All the causes of headaches are not fully understood and many patients are suffering from headaches triggered by more than one cause. However, we do know that many headaches are directly related to malocclusion. If a patient’s headache is attributed to his or her occlusal problem, he may expect total and complete relief. However, if there is more than one cause contributing to the headaches, the patient will feel varying degrees of improvement.
What degree of success can I expect?
Everyone has limitations which make it impossible to guarantee success from occlusal treatment. We will discuss certain areas, if any, that occlusal equilibration and/or restoration will not improve. We will, however, make every effort to do what we can to give you the best results possible. Your expectations and desires of the results should be expressed so that you and the dentist are working towards the same goals.
How will my bite feel?
When equilibration is completed, you will experience the comfortable feeling of all your teeth touching equally. Once your bite is balanced you will hear and feel your teeth “clack” together properly …an interesting sound! You will also notice that your mouth muscles become relaxed and your jaw will feel looser.
EFFECTS OF MALOCCLUSION
Jaw muscle pain or soreness, Jaw muscle tightness, Headache, Jaw muscle dysfunction (TMD). , Jaw joint pain,, Jaw joint clicking, Jaw Locking, Joint dysfunction, Decreased jaw mobility, Tooth wear, Tooth fracture, Notching at the necks of the teeth, Tooth sensitivity, Toothache nerve damage requiring root canal treatment, Gum and tooth attachment damage, Tooth loosening, Bone loss and Tooth loss.